NHS makes fresh uptake appeal as five million women not up to date with cervical screening

Women are being urged to come forward for cervical screening as new figures show more than five million are not up to date with their routine check-ups.

The NHS invites women for screening every three to five years depending on their age, or more frequently if the high-risk human papillomavirus (HPV) is detected, with the programme saving thousands of lives annually.

The NHS Cervical Screening Programme, England 2023-2024 annual report, published by NHS England today, found that 68.8% of 25 to 64-year-olds were screened within the recommended period of time, compared to 68.7% the previous year. Coverage was higher for 50 to 64-year-olds at 74.3% compared with 25 to 49-year-olds at 66.1%.

In 2023-24, everyone who was due a test – a total of 5.12 million individuals aged 25 to 64 in England – was invited to book an appointment, and 3.25 million were tested during the year.

Last year, the NHS pledged to eliminate cervical cancer by 2040 by making it as easy as possible for people to get the lifesaving HPV vaccination and encouraging more women and people with a cervix to come forward for their cervical screening.

Earlier this month, the NHS set out reforms to fully digitise screening – by announcing the rollout of a new “ping and book” service that will send alerts to phones to remind women they are due or overdue an appointment. The plans will begin with invitations for breast screening being sent directly through the NHS App, and be expanded to include cervical screening in Spring 2025. 

NHS cervical screening helps prevent cervical cancer by using a highly effective test to check for HPV, which is found in over 99% of all cervical cancers and which may cause abnormal cells to develop in the cervix. These abnormal cells can, over time, turn into cancer if left untreated.

Women who are due a cervical screening appointment will receive invitation letters by post when it’s time to book. Appointments can be booked through GP practices and some sexual health clinics also offer the service. Anyone who has previously received an invitation and been unable to attend shouldn’t wait for another invitation – you can still book a cervical screening appointment even if invited weeks, months or years ago.

Sue Mann, NHS England’s National Clinical Director for Women’s Health, said: “We have set ourselves an ambitious target of eliminating cervical cancer by 2040 – a commitment shared by only a few countries worldwide.

“In order to achieve this, we are working hard to ensure that everyone who’s eligible has access to HPV vaccination and cervical screening appointments, and that they are suitably informed on how to book and what to expect at an appointment.

“If we are to make real inroads into eradicating cervical cancer, it’s essential that everyone who is invited for screening comes forward when invited.

“If you have previously missed your appointment, do not hesitate to reach out to your GP practice or sexual health clinic to schedule a new one. Taking this proactive step could potentially save your life.”

Sophia Lowes, Senior Health Information Manager at Cancer Research UK, said: "Cervical screening saves thousands of lives every year in the UK. It's for people without symptoms and helps to prevent cervical cancer from developing in the first place. Cancer Research UK encourages everyone who receives an invitation to take part.

"Some people may have found cervical screening uncomfortable in the past or have experienced other barriers to taking part. But there are things you can ask for to help you feel more comfortable, such as asking for a nurse of a specific gender or asking for a smaller speculum - the tool that nurses use to look at your cervix. You can also ask for a longer appointment so you can talk through any concerns with the nurse on what adjustments you might need.

"On top of this, the NHS in England is taking steps to make it easier to take part in cervical screening, such as letting you book your appointment through the NHS App. In the future, innovations like HPV self-sample kits, which allow people to collect a sample for testing themselves, could help more people take part. We’re looking forward to seeing the impact these new initiatives could have."

Helen Hyndman MBE, Nurse Service Co-ordinator for The Eve Appeal, said: "Having the HPV vaccination and attending cervical screening appointments, when invited, is vital to prevent cervical cancer. We encourage anyone who has received their invitation or whose test is overdue, to book their appointment.

"We recognise that cervical screening can be a difficult, painful or traumatic experience for many women and people with a cervix, we are here to ensure they have the right information and support available to them to help them through the process. Our Ask Eve nurses are always here to help with free and confidential advice. To get in touch email nurse @ eveappeal.org.uk or call 0808 802 0019."

The HPV vaccine protects against cervical cancer as well as other cancers including anal, mouth and throat, head and neck and penile cancers caused by the HPV virus. It is offered to girls and boys in secondary school to protect them against catching the HPV infection and developing into pre-cancerous and cancer cells. Girls under 25 years old can get their vaccination, while boys born after 1 September 2006 are also eligible.

It is still important to attend cervical screening appointments if you have been vaccinated against HPV as the vaccine does not provide protection from all types of HPV, so there is a still a small chance of getting cervical cancer.

Health and care professionals will be supported to identify those who most need the HPV vaccine through targeted outreach and offering jabs in more convenient settings.

Louise Ansari, chief executive of patient champion Healthwatch England, said: “We know from stories women have shared with us that fear of pain, embarrassment, past trauma, or misconceptions about HPV can stop them booking a screening appointment. That’s why we want everyone eligible for cervical screening to know that options are open to them to make this process more comfortable.

“These include longer appointments to discuss concerns or ask questions beforehand, bringing in a professional or personal chaperone, the health professional using different-sized equipment, and even the type of clothing you can keep on throughout.

“Women also told us in our recent research that they want more convenient booking methods and times to fit screening around caring and work responsibilities. We’re pleased NHS England has responded with recent news that they will start issuing screening invites via the NHS App from next year.”

England is among the first countries in the world to set the elimination ambition for cervical cancer within the next two decades.

The World Health Organization considers cervical cancer to be eliminated as a public health problem when there is an incidence rate lower than four per 100,000 women.

More information on NHS cervical screening and how to book an appointment is available at www.nhs.uk/conditions/cervical-screening.

Read the full report: NHS Cervical Screening Programme, England 2023-2024